Managing comorbidities in idiopathic pulmonary fibrosis

Abstract

Major risk factors for idiopathic pulmonary fibrosis (IPF) include older age and a history of smoking, which predispose to several pulmonary and extra-pulmonary diseases. IPF can be associated with additional comorbidities through other mechanisms as either a cause or a consequence of these diseases. We review the literature regarding the management of common pulmonary and extra-pulmonary comorbidities, including chronic obstructive pulmonary disease, lung cancer, pulmonary hypertension, venous thromboembolism, sleep-disordered breathing, gastroesophageal reflux disease, coronary artery disease, depression and anxiety, and deconditioning. Recent studies have provided some guidance on the management of these diseases in IPF; however, most treatment recommendations are extrapolated from studies of non-IPF patients. Additional studies are required to more accurately determine the clinical features of these comorbidities in patients with IPF and to evaluate conventional treatments and management strategies that are beneficial in non-IPF populations.

Keywords:

• interstitial lung disease
• management
• idiopathic pulmonary fibrosis
• comorbidities

Acknowledgments

Christopher J Ryerson is supported by a Career Investigator Award from the Michael Smith Foundation for Health Research.

Disclosure

CJR has received speaking honoraria and research funding from Hoffman-La Roche Ltd and Boehringer Ingelheim. BGF reports no conflicts of interest in this work.